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Clin Case Rep . COVID-19 presenting as severe acute hepatitis in a pediatric patient with thalassemia minor: A case report

tetano

Editor, Senior Moderator
Clin Case Rep


. 2024 May 24;12(6):e8955.
doi: 10.1002/ccr3.8955. eCollection 2024 Jun. COVID-19 presenting as severe acute hepatitis in a pediatric patient with thalassemia minor: A case report

Syed Abdan Jamalvi[SUP] 1 [/SUP], Sameer Abdul Rauf[SUP] 1 [/SUP], Atika Sherali[SUP] 2 [/SUP], Syed Khizar Ali[SUP] 1 [/SUP], Hussain Haider Shah[SUP] 1 [/SUP], Filza Jamalvi[SUP] 1 [/SUP], Fnu Yogeeta[SUP] 1 [/SUP], Tirth Dave[SUP] 3 [/SUP]



Affiliations
Abstract

Key clinical message: This case emphasizes the significance of COVID-19 in pediatric patients presenting with unusual hepatic manifestations, urging clinicians to broaden their diagnostic lens. The unexpected elevation of SARS-CoV-2 antibodies and the effective use of N-acetyl cysteine highlight the importance of adaptability in treatment strategies.
Abstract: This case report presents a unique manifestation of severe hepatic involvement in a 4-year-old girl with thalassemia minor and COVID-19. Despite the absence of prominent respiratory symptoms, the patient exhibited jaundice, elevated liver enzymes, and coagulopathy. Initial suspicion of viral hepatitis was replaced by the discovery of significantly elevated SARS-CoV-2 antibodies. A multidisciplinary approach, including gastroenterology consultation and an extensive workup, was pivotal in ruling out alternative etiologies. Unconventional use of N-acetyl cysteine contributed to clinical improvement, highlighting the need for adaptable treatment strategies. This case underscores the importance of heightened awareness in recognizing atypical presentations of COVID-19 in pediatric patients, especially those with underlying health conditions. Further exploration into nuanced manifestations and treatment approaches is warranted for comprehensive clinical management.

Keywords: COVID‐19; SARS‐CoV‐2; coronavirus; hepatitis; thalassemia.

 
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